| NPI | 1326898875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2025-0140) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 0000000000) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2025-06-06 |